Individual
TRACY L HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
201 HEALTH CARE DR, GREENVILLE, IL 62246-1155
(618) 664-1380
(618) 664-4239
Mailing address
200 HEALTH CARE DR, GREENVILLE, IL 62246-1154
(618) 664-1380
(618) 664-4239
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036083073
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036083073
—
IL
Enumeration date
09/12/2005
Last updated
12/27/2021
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